• PIERRE, S.D. (AP) -- Some lawmakers and health care groups plan to ask the South Dakota Legislature next month to expand the state's Medicaid program to cover the medical costs of 48,000 more poor people, despite resistance from Gov. Dennis Daugaard.
• Daugaard last week told state lawmakers he is not recommending the Medicaid expansion, available to states as an option under the federal health care overhaul, as part of next year's state budget. He said the federal government is having trouble putting the entire overhaul into effect. He also wonders whether the federal government can meet its pledge to pay most of the cost of the expansion.
• "I have continuing doubts about the federal government's ability to deliver on its promises," the Republican governor said.
• But supporters said an expansion is needed to improve health care for poor people who now wait until they are seriously ill before seeking medical care. They said hospitals are not paid for that emergency care and cover the loss by boosting charges to patients with private insurance.
• Cathy Brechtelsbauer of Sioux Falls, an advocate for low-income people, said she talks to many who don't qualify for Medicaid but can't afford to buy even the subsidized insurance available under the new health care law.
• "I don't think we can sleep well at night until we get these people covered. These are our neighbors. These are our fellow citizens," Brechtelsbauer said.
• Rep. Bernie Hunhoff of Yankton, leader of the House Democratic minority, said measures seeking to expand Medicaid will be introduced in the legislative session that opens Jan. 14, but lawmakers won't make a final decision until late in the session when they pass next year's state budget.
• "That's a moral imperative. It should not be put off for another year," Hunhoff said. "Most of them are people who are working two or three part-time jobs with low wages. They are working hard trying to provide for themselves, but they cannot begin to buy health insurance in the marketplace."
• President Barack Obama's health care law seeks to provide more people with insurance through subsidized private insurance offered through online marketplaces called exchanges. States also have the option of expanding Medicaid to cover peo

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